<div class="layui-card-body">
    <form class="layui-form" action="{:url()}" method="post">
        <div class="layui-container">
            <div class="layui-row">
                <div class="layui-col-md6">
                    <div class="layui-form-item">
                        <label class="layui-form-label">地市</label>
                        <div class="layui-input-block">
                            <select name="city" lay-search>
                                <volist name="city" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.city">
                                        <eq name="$k" value="$info.city">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">县区</label>
                        <div class="layui-input-block">
                            <select name="sub_city" lay-search>
                                <volist name="sub_city" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.sub_city">
                                        <eq name="$k" value="$info.sub_city">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">姓名</label>
                        <div class="layui-input-block">
                            <input type="text" name="name" value="{$info.name|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">性别</label>
                        <div class="layui-input-block">
                            <select name="sex" lay-search>
                                <volist name="sex" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.sex">
                                        <eq name="$k" value="$info.sex">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">年龄</label>
                        <div class="layui-input-block">
                            <input type="text" name="age" value="{$info.age|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">国籍</label>
                        <div class="layui-input-block">
                            <select name="noun" lay-search>
                                <volist name="noun" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.noun">
                                        <eq name="$k" value="$info.noun">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">证件号码</label>
                        <div class="layui-input-block">
                            <input type="text" name="card" value="{$info.card|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">来自国</label>
                        <div class="layui-input-block">
                            <input type="text" name="fornoun" value="{$info.fornoun|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">入境时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="visa_time" value="{$info.visa_time|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="visa_time" readonly>
                        </div>
                    </div>
                </div>
                <div class="layui-col-md6">

                    <div class="layui-form-item">
                        <label class="layui-form-label">车/船/航班</label>
                        <div class="layui-input-block">
                            <input type="text" name="visa_type" value="{$info.visa_type|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">入境地点</label>
                        <div class="layui-input-block">
                            <input type="text" name="visa_city" value="{$info.visa_city|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">是否发热</label>
                        <div class="layui-input-block">
                            <select name="is_hot" lay-search>
                                <volist name="yes_no" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.is_hot">
                                        <eq name="$k" value="$info.is_hot">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">是否确诊/疑似</label>
                        <div class="layui-input-block">
                            <select name="is_really" lay-search>
                                <volist name="yes_no" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.is_really">
                                        <eq name="$k" value="$info.is_really">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">是否密切接触者</label>
                        <div class="layui-input-block">
                            <select name="is_contact" lay-search>
                                <volist name="yes_no" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.is_contact">
                                        <eq name="$k" value="$info.is_contact">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">隔离措施</label>
                        <div class="layui-input-block">
                            <input type="text" name="isolate" value="{$info.isolate|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">所在隔离点</label>
                        <div class="layui-input-block">
                            <input type="text" name="spot" value="{$info.spot|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">隔离点地址</label>
                        <div class="layui-input-block">
                            <input type="text" name="isolate_address" value="{$info.isolate_address|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>

                </div>
            </div>
            <hr>
            <div class="layui-row">
                <div class="layui-col-md6">
                    <div class="layui-form-item">
                        <label class="layui-form-label">医学观察时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="medical_time" value="{$info.medical_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="medical_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">是否解除隔离</label>
                        <div class="layui-input-block">
                            <select name="is_isolate" lay-search>
                                <volist name="yes_no" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.is_isolate">
                                        <eq name="$k" value="$info.is_isolate">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">隔离状态</label>
                        <div class="layui-input-block">
                            <select name="isolate_status" lay-search>
                                <volist name="isolate_status" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.isolate_status">
                                        <eq name="$k" value="$info.isolate_status">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>

                </div>
                <div class="layui-col-md6">
                    <div class="layui-form-item">
                        <label class="layui-form-label">解除隔离时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="free_isolate_time" value="{$info.free_isolate_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="free_isolate_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">转归状态</label>
                        <div class="layui-input-block">
                            <select name="move_status" lay-search>
                                <volist name="move_status" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.move_status">
                                        <eq name="$k" value="$info.move_status">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">转归时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="move_time" value="{$info.move_time|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="move_time" readonly>
                        </div>
                    </div>

                    <div class="layui-form-item">
                        <label class="layui-form-label">检测单位</label>
                        <div class="layui-input-block">
                            <input type="text" name="group" value="{$info.group|default=''}" class="layui-input"
                                   autocomplete="off"
                                   placeholder="">
                        </div>
                    </div>
                </div>
            </div>
            <hr>
            <div class="layui-row">
                <div class="layui-col-md6">
                    <div class="layui-form-item">
                        <label class="layui-form-label">第一次检测时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_1_time" value="{$info.test_1_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_1_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第一次报结果时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_1_ok_time" value="{$info.test_1_ok_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_1_ok_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第一次检测结果</label>
                        <div class="layui-input-block">
                            <select name="test_1_status" lay-search>
                                <volist name="test_ok" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.test_1_status">
                                        <eq name="$k" value="$info.test_1_status">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第二次检测时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_2_time" value="{$info.test_2_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_2_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第二次报结果时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_2_ok_time" value="{$info.test_2_ok_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_2_ok_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第二次检测结果</label>
                        <div class="layui-input-block">
                            <select name="test_2_status" lay-search>
                                <volist name="test_ok" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.test_2_status">
                                        <eq name="$k" value="$info.test_2_status">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第三次检测时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_3_time" value="{$info.test_3_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_3_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第三次报结果时间</label>
                        <div class="layui-input-block">
                            <input type="text" name="test_3_ok_time" value="{$info.test_3_ok_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="请选择时间" id="test_3_ok_time" readonly>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">第三次检测结果</label>
                        <div class="layui-input-block">
                            <select name="test_3_status" lay-search>
                                <volist name="test_ok" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.test_3_status">
                                        <eq name="$k" value="$info.test_3_status">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                </div>
                <div class="layui-col-md6">

                    <div class="layui-form-item">
                        <label class="layui-form-label">IgM抗体检测结果</label>
                        <div class="layui-input-block">
                            <select name="igm" lay-search>
                                <volist name="test_ok" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.igm">
                                        <eq name="$k" value="$info.igm">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">IgG抗体检测结果</label>
                        <div class="layui-input-block">
                            <select name="igg" lay-search>
                                <volist name="test_ok" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.igg">
                                        <eq name="$k" value="$info.igg">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">手机号</label>
                        <div class="layui-input-block">
                            <input type="text" name="mobile" value="{$info.mobile|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="" id="mobile" >
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">职业</label>
                        <div class="layui-input-block">
                            <select name="job" lay-search>
                                <volist name="job" id="vo" key="k">
                                    <option value="{$k}"
                                    <notempty name="info.job">
                                        <eq name="$k" value="$info.job">selected="selected"</eq>
                                    </notempty>
                                    > {$vo} </option>
                                </volist>
                            </select>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">关联病例姓名</label>
                        <div class="layui-input-block">
                            <input type="text" name="json_user" value="{$info.json_user|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="" >
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">关联病例证件号码</label>
                        <div class="layui-input-block">
                            <input type="text" name="json_card" value="{$info.json_user|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   placeholder="" >
                        </div>
                    </div>
                    <div class="layui-form-item layui-form-text">
                        <label class="layui-form-label">备注</label>
                        <div class="layui-input-block">
                            <textarea name="info" class="layui-textarea">{$info.info|default=""}</textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">个案添加时间</label>
                        <div class="layui-input-block">
                            <input type="text"  value="{$info.c_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                   readonly >
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">最后更新时间</label>
                        <div class="layui-input-block">
                            <input type="text"  value="{$info.u_time|default=''}"
                                   class="layui-input"
                                   autocomplete="off"
                                  readonly >
                        </div>
                    </div>
                </div>
            </div>
        </div>
<input type="hidden" name="id" value="{$info.id|default=''}">
</form>
</div>

<script type="text/javascript">
    layui.use(['form', 'layer'], function () {
        var form = layui.form
            , $ = layui.$
            , laydate = layui.laydate;
        laydate.render({
            elem: '#visa_time'
        });
        laydate.render({
            elem: '#medical_time'
        });
        laydate.render({
            elem: '#move_time'
        });
        laydate.render({
            elem: '#test_1_time'
        });
        laydate.render({
            elem: '#test_1_ok_time'
        });
        laydate.render({
            elem: '#test_2_time'
        });
        laydate.render({
            elem: '#test_2_ok_time'
        });
        laydate.render({
            elem: '#test_3_time'
        });
        laydate.render({
            elem: '#test_3_ok_time'
        });
        laydate.render({
            elem: '#free_isolate_time'
        });

    });

</script>






